eHealth in a caring society

2 september 2015

Helping others makes us happier, and we have the research to prove it. But how do we keep it ‘light’? How do we share the work as equally as possible? What digital developments are useful and how do they complement each other? This article focuses on everyday tools for the development of digital market places where matches are made between supply and demand in our caring society.

This article has been published in ‘Co-creatie eHealthboek: nieuwe inspiratie voor de uitdagingen in de zorg’ (Co-creation eHealthbook: new inspiration for the challenges in healthcare), December 2014.

Taking care of another person makes you feel good. The Netherlands Institute for Social Research (SCP) found that informal carers who help another person for 3 hours a week on average, assess their lives as happier than people who spend more, less or no time at all on helping other people. In other words, a limited amount of informal care increases happiness; (too) much of it makes us unhappy. Anybody who has intensively cared for a loved one, temporarily or long-term, will recognize this.

Concerns

Consequently, it comes as no surprise that the opinions on the transformations in the field of care are adverse, to say the least. A large group of people is concerned about the plans to ask more effort of (sometimes overwrought) informal carers. Others embrace the opportunity and offer neighbourly services on digital market places called Wehelp or Neighbours. Both the concerns and the enthusiasm are real: caring for another person is significant but it can become aggravating.

Finding balance

Knowing this, the key to success is to find the right balance; to develop an understanding for both sides of the story. It is safe to say that the need for closer and better collaborations between the (im)possibilities of self help, informal care, volunteers, neighbourhood services and citizen’s initiatives on the one hand and formal care on the other will grow considerably. Next to this, to reach an optimal joint venture there are various practical problems to tackle. Family members have more often than not spread out over the country which sometimes complicates communications between different care givers. And how to make sure that dedicated volunteers are linked to the right persons?

Digital care 

From 2007 onwards, more and more online platforms and communication tools that are aimed at (partly) tackling these issues have been developed. Where do we stand today? We will take you through it. From games and tools that we all know - Whatsapp, Google calendar or Wordfeud – via digital communication tools that were developed especially for care professionals to the digital market places aimed at matching local neighbourly help. Finally, we will discuss the most recent digital environments which appear to be combining multiple functions.

Daily care, daily tools

From her student room in Utrecht, Marije is Skyping her granddad in his care home in Delft, 40 km away. Herman sits down after dinner to play a game of Wordfeud with his 80-year-old mother. Janice keeps her family and friends up to date about her treatment and experiences by keeping a blog journal. And Ricardo is that ‘smart’ cousin who has set up a shared Google calendar for the entire family to coordinate the visits to aunt Angela at the hospital.

Inevitable

It is perfectly logical that we use new communication tools to be in contact more or differently with the people we care about. We even see a growing number of care givers starting to use modern tools. There are situations where it is more effective to use Whatsapp to put a question to your counsellor directly, instead of waiting for the weekly walk-in hours. In addition, since 2007 a great deal of online tools emerged that were specifically designed for communication or logistics in the field of care.

Digital communication: the technique is already there

There are already about twenty different digital environments in the Netherlands that are built up around a particular person, his or her family or friends and the formal care parties involved. These applications mostly operate within one shared digital environment and offer a range of functions, like a shared planner, photo’s, a journal, video calling, a secured area to share data, make plans and allocate tasks.

Differences and similarities

There are many similarities but all applications have their own specific features. For example, they have all been developed from a particular perspective or for a specific group or they are based on a different economical model. Some applications are free, like Deelgenoot, BucketLine, Bloomily or Carenzorgt, sometimes there is a monthly fee, like with ShareCare Zorgsite or ABCTV, and other software is bought by the care provider and offered to their clients and network as a free service, like with Familienet or Mextra.

Unknown, unloved

A user survey among users of the application ShareCare Zorgsite tells us that although clients, informal care givers and family members are generally very positive about the application, professional carers haven’t started using it actively yet. An explanation could be that individual care givers find it difficult to participate in a digital environment which is incompatible with their own work processes. Also, it is virtually impossible to keep up if every family chooses another tool or system to communicate.

And then there is the well known fear of the unknown: what about privacy and the thin line between work and home? Care organisations that run an active policy on network building and family participation can’t ignore digital communication in their programmes. If care organisations allow their employees enough time and space and manage to closely involve clients and their families in the choice for a particular tool, in the end all parties will benefit a great deal.

Digital market places: from hype to productivity?

WeHelpen, Miess, Nettie, Vraagelkaar, Zorgvoorelkaar, Dominozorg, Buuv, Tijdvoorelkaar, Hulpinjebuurt, Burenhulpcentrale and Eigenzorg. Eleven Dutch examples of online market places which were launched in the past few years to match supply and demand of small services, like chores around the house, food shopping, and going for a walk. Some platforms operate on a national level, others like to keep it local. And there is more! If you are looking for a home cooked meal, since a year or so, all you have to do is go to Thuisafgehaald.nl.

And what about sites that combine free services with paid offers like NationaleHulpgids, Wijzorg or BeterThuis? Regelhulp.nl is the government’s answer to online support and assistance. In short, are we dealing with a trend. Or is it a hype, after all?

Figure 1: the Gartner Hype Cycle

The Gartner Hype Cycle

Figure 1 shows us the Gartner Hype Cycle. A common graph used by innovation managers to define and recognize the different phases of a technological breakthrough. Phase 1 is the technological trigger. New attractive concepts get noticed by media and investors. No working products have been developed as yet. The attention builds to a peak of inflated expectations: phase 2. After this, the first negative publicity and stories of failed experiments appear. The application now needs to survive phase 3: the through of disillusionment. Only if the developers are able to adjust to the needs of the early users, the investments will keep coming in. Then, the concept will move up via the ‘Slope of Enlightenment’ towards productive applications of the technique.

After the hype

The big hype and the high expectations around digital market places have indeed been tempered. We have also seen the first failures. One of the problems was a surplus of offers and not enough demand, resulting in too little successful matches. Another much heard argument is that online market places are unsuitable for the truly vulnerable group of people as they are unaware of who they are actually inviting via the web. However, if the Gartner Hype Cycle does apply here, we might just find ourselves right in the middle of the phase of enlightenment. And straight on to the last stage: phase 5 the Plateau of Productivity.

The new volunteer

The rise of digital market places is closely connected to the volunteer 2.0, who is all about self planning, matching and short term commitment. The international volunteer organization NederlandCares has responded to this need for flexibility by offering weekly activities in the large cities where people can choose to contribute as a one-off experience or as often as they like.

Matching is nothing new

The principle of matching supply and demand is by no means a new phenomenon. The Netherlands has always been at the top of the list in volunteer work, in care as well as in other fields. These experiences can contribute to the further development of digital market places. Established and well known volunteer organisations like Humanitas and De Zonnebloem as well as local volunteer services have a tremendous amount of experience in long term matching of buddies and supply and demand, often via a simple telephone service with an effective digital address book and obviously thanks to the experience and expert social skills of the matchmaking coordinators. If digital market places are not yet learning from them, they should waste no more time and go see them now.

Joining care groups?

Another way to go is to use the energy that is already prompted by local care groups in their towns and neighbourhoods: initiatives that bring people together to take care of each other. There are people who offer to do shopping, or fix things around the house, people who may need transportation or special help for medical reasons and sometimes even specialist nursing. Among the key objectives of every match are always getting to know each other, spending time and having fun. In the summer of 2014, Vilans drew up a list of all Dutch citizen initiatives. As we speak there are 75 known initiatives and more are added every month. Especially in Amsterdam and the province Brabant the trend seems to be booming.

The new generation: 3-in-one?

Although in this article we have deliberately distinguished between digital communication and interaction within one network on the one hand and digital market places on the other, we also see them coming together. In Quli, for example, it is possible to enter a personal health platform which combines multiple functions. Anyone with a Quli account can use it to manage their personal plan and appointments as well as invite informal networks and post appeals on a service site (WeHelpen). Also, the Wehelpen site has recently begun to offer the possibility to organise care and support among friends and acquaintances.

New care ventures

Like Quli, applications such as Mextra and apps like BigMove or ikracht could be ranged under the new generation of online care plans. Clients often regard traditional care plans as ‘files of the care organization’. More often than not they are indeed hard to get access to and the language used is too formal or complicated. We will not try to explain all the current problems and developments concerning care plans here, but it is safe to say that the traditional form does not suit the average user, or stimulate any form of self management. Therefore, the movement towards online, accessible platforms where clients can co-create and adjust their personal care plans is a positive development. The fact that informal carers, family and friends are also involved seems to be perfectly logical. We are curious to see whether the 3-in-1 variants will indeed take off and take the lead. Or will we rather separate the three functions (making plans, communicating with our social network and managing voluntary services) and develop and use distinctive separated tools in the future.

Feedback?

In no way do we wish to pretend that this article holds all there is to say about the subject. As of yet, too little independent research has been done on user’s experiences. All we can really do is take a guess where everything is going. Do you disagree? Have we missed applications or trends? Do you see new opportunities? Your experiences and feedback are more than welcome. Please email us: Floor de Jong, Yvonne de Jong or Brechtje Walburgh Schmidt. Brechtje Walburgh Schmidt spoke about eHealth in a caring society during the International Carers Conference (3-6 September 2015).

Literature

  • Boer, A. de (2007). Mantelzorg. Een overzicht van de steun van en aan mantelzorgers in 2007. Den Haag: SCP.
  • Joling, K., H. van Hout, F. Schellevis, H. van der Horst, P. Scheltens, D. Knol en H van Marwijk (2010). Depressie en angst bij partners van dementiepatiënten
  • Jong, Y. (2013) Familieparticipatie 2.0. Digitale communicatie verbetert de relatie met de familie. In Kwaliteit in Zorg
  • Palmboom, G. & Pols, J. (2008). Wat bezielt de mantelzorger? Den Haag: Nicis Institute.
  • Simac (2014) Gebruikersonderzoek ShareCare Zorgsite 'Samen mantelzorgen verlicht de zorg'

Read this article in Dutch.